Joint Damage

Overview of joint damage

Degeneration of musculoskeletal structures is a common occurrence at the onset of old age. They lead to numerous complications and may even cause chronic disability. A common disorder belonging to the above category is “joint damage”. The epidemiological studies by the Arthritis Foundation, United States suggest that nearly 40.9% of the adult population with diabetes will suffer from some form of joint disease. Now, joint damage and diseases are common in young adults, teens and small children. Numerous factors are responsible for these incidences. At present, the joint damage has become a major global health burden. It affects performance and productivity in different spheres.

What is joint damage?

Joint damage is a collective term for a group of conditions which cause degeneration and damage of the bones, joints, and cartilages, leading to temporary or permanent disability.

Mechanical injury, loss of mineral content of bones or structural deformities may precipitate this condition.

In a majority of the cases, joint damage is manifested as pain, inflammation, swelling, and in worst cases, immobility of the vital joints in the body.

At present, joint damage is one of the primary causes of disability in old people. Statistics show that joint damage affects people of all age groups, genders and ethnic groups worldwide.

What causes joint damage?

Joint damage is caused by multiple environmental, physiological and genetic factors. The commonly analyzed causes are described below-

• Natural degeneration of joints and cartilages with age
• Degeneration of synovial fluid present in the joints (knee joints), leading to increased friction
• Erosion of cartilage tissues
• Bones become very porous (cause: mineral loss)
• Infection and inflammation of cartilage tissues
• Autoimmune diseases (defects in Protein Tyrosine Phosphatase 22 gene) that affect the synovium tissues
• Hormonal fluctuations after menopause
• Mechanical injury
• Infections or diseases of the joints
• Deficiency of vitamins (Vitamin C and D) and essential micronutrients in the regular diet
• Rigorous physical activities
• Stress and strain on muscles, bones, and joints (common in people who lift loads or stand for long hours. Eg: Factory workers)
• A few food items like processed meat, refined carbohydrates, and artificial fats (cause joint inflammation and pain)
• History of joint diseases in the family
• Obesity and overweight conditions (exert pressure on knee and ankles)
• Over-the-counter drugs like antihistamines, corticosteroids, tranquilizers, diuretics etc
• Incorrect body postures
• Accidental bending or twisting (may cause injury to the meniscus, ligament or tendons)
• Accumulation of waste products (Eg: uric acid) in the body
• Chemicals like lead, arsenic, cadmium, benzene or mercury (induce toxicity)
• Low intake of fluids
• Defective metabolism
• Congenital defects

What are the warning signs of joint damage?

Joint damage is easily recognized through some common symptoms. These are described below-

• Pain and inflammation in joints
• Joints become stiff and immobile in the morning
• Redness, warmth and increased tenderness of affected joints
• Bones that stick at different locations form bulges
• The occurrence of sudden shooting pain and burning sensation in and around the joints
• Pain may radiate from joints to the nearby areas like pelvic region, lower back or lower extremities
• Bone deformities
• Peeled off whitish flakes from the skin covering affected joints
• Difficulty performing normal activities like walking, running, climbing stairs etc
• Restricted motion of joints
• Fever and general body weakness
• Body pain
• Loss of appetite
• The height of a person reduces (erosion of joints in the vertebra forms humps and affects the height)
• Joint movements lead to sounds at the joints
• Throbbing pain in joints and adjoining muscles after some physical activity or normal movements
• Joint pain at night disturbs sleep
• The patient cannot restore proper postures

What are the different types of joint damage?

As a person grows old, the joints degenerate. This predisposes the body to several joint diseases. These are as follows

• Osteoarthritis: Osteoarthritis is the most severe type of joint damage. Here the joints, muscles and the nearby tissues erode and degenerate. Pain and inflammation of joints occur in this disease. The bones may protrude at odd locations. This may lead to deformed bones. The patients may experience immobility at the very end stage of the disease.
• Rheumatoid arthritis: It is a type of joint damage wherein inflammation of the linings of the joints occurs. This can cause bone displacement and bone erosion. This condition severely affects the joints of the cervical spine, hands, feet, and knees.
• Osteoporosis: In this type of joint damage, essential minerals are lost from the bones. Most of the bones become brittle and porous. Here, the rate of bone degradation (resorption) exceeds the rate of bone formation.
• Paget’s disease: It is a type of metabolic bone disease. Here the bones get replaced by fibrous tissues. This causes joint damage.
• Osteomalacia: Osteomalacia is a type of joint damage in which the bones become very soft. Deficiency of Vitamin D or calcium in the body triggers this condition.
• Osteomyelitis: In this disease, bacteria infect the bones and bone marrow.
• Gout: Gout is a joint disease in which excess waste products build up in the body. The most common waste product is “uric acid crystals”. Acute joint pain and inflammation occurs in this condition.
• Degenerative disc disease: It is a kind of joint damage caused by erosion and dislocation of vertebral discs.

What diagnostic tests are necessary?

A few diagnostic tests are essential to detect the exact cause of joint damage-

• X-rays (to look for damage of joints or cartilages)
• Synovial fluid analysis (to detect presence of crystals)
• MRI scan (to detect injuries in joints and cartilages)
• CT scan
• Digital radiography

Treatment and prevention

Osteoarthritis 

Treatment 

• Medications to help relieve pain and reduce inflammation are prescribed.An antidepressant is prescribed to those with osteoarthritis to help relieve pain.
• Individual therapies such as physiotherapy can help in strengthening muscles and increasing mobility in the joints.
• Ways to reduce stress in the patient’s lifestyle will be taught during occupational therapy. Here, the patients are taught ways to help make their day-to-day activities easier by reducing stress levels and pain.
• Certain exercises can help in stretching the muscles and increase mobility. Tai chi and yoga can help in reducing stress levels and increasing muscle strength.
• In case other treatment methods do not work, surgery is done to help realign the joints or replace the joints depending on the severity of osteoarthritis.

Prevention 

• Maintain a healthy body weight.
• Do not indulge in first or second-hand smoking.
• Maintain a clean and healthy diet.
• Get a regular checkup done if you are above the age of 50 years.

Osteoporosis 

Treatment 

• In cases, if the risk of fracture is low, doctors recommend that the patient gets a good amount of exercise to help maintain mobility and flexibility. They also look at ways in which they can help ease the symptoms of the conditions.
• Medications to help retain the bone density are prescribed to reduce pain.
• Certain home therapies such as taking estrogen supplements help in increasing bone density.

Prevention 

• Maintain a healthy diet.
• Get sufficient amounts of vitamin D.
• Exercise regularly.
• Maintain a healthy body weight.

Gout 

Treatment 

• Medications to help reduce the attacks of gout are prescribed. These medications may start off on a higher dosage, but over time the dosage of the medications are reduced.
• Medications that can help relieve pain and inflammation are prescribed to those with gout. These medications can be consumed orally or injected into the joints.

Prevention 

• Stay hydrated.
• Maintain a healthy body weight.
• Maintain a clean and healthy diet.

Paget disease 

Treatment 

• If the symptoms of Paget’s disease are not as severe, treatment will not be necessary. In case, the symptoms increase, treatment options will be considered.
• Medications that are prescribed to osteoporosis patients will be prescribed to those who have been diagnosed with Paget’s disease. These medications help in reducing the symptoms and increase bone density.
• In rare cases, surgery may be required to help fractures heal, replace damaged joints, realigning joints and reducing the pressure on the knees.

Prevention 

• Maintain a healthy diet.
• Exercise regularly.
• Ensure that you do not fall.

References